Bcl-2 family proteins are anti-apoptotic proteins associated with cancer and other diseases. Bcl-2 family proteins under investigation as therapeutic targets include Bcl-2 (BCL2), Bcl-xL (BCL2L1), Bcl-w (BCL2L2), A1 (BCL2A1), and MCL1 (MCL1). Numerous cancers express one or more Bcl-2 family proteins leading to cancer cell survival and resistance to chemotherapeutics. For example, chromosomal translocation of Bcl-2, t(14; 18), is a transforming event in some cancer cells (Raffeld, et al. Cancer Research 1987, 47(10):2537-42), and these cancer cells demonstrate dependence on Bcl-2 for survival based on RNAi (FIG. 1), and sensitivity to recently described small molecule inhibitors of Bcl-2 family proteins (Oltersdorf, et al. Nature 2005, 435, 677-681; Deng et al. Cancer Cell 2007, 12(2), 171-185). This invention is directed to a series of compounds that inhibit Bcl-2 family proteins and promote apoptosis of cancer cells, alone or in combination with other chemotherapeutics.
In addition to B-cell lymphomas, Bcl-2 family antagonists have been shown to be useful for treating cancers that express Bcl-2 family members and/or have deregulated apoptosis such as chronic lymphocytic leukemia, diffuse large B-cell lymphomas, follicular lymphomas, chronic or acute leukemia, chronic myeloid leukemia, lymphoid malignancies of T-cell or B-cell origin, small cell lung cancer, non-small cell lung cancer, melanoma or other skin cancers, multiple myeloma, ovarian cancer, breast cancer, colon cancer, gastrointestinal cancer (gastric, colorectal, and duodenal), prostate cancer, bladder cancer, uterine cancer, cervical cancer, sarcoma of soft tissue origin, pancreatic cancer, kidney cancer, brain tumors, hepatocellular cancer, head and neck cancer, cervical cancer, fibrosarcoma, and other cancers.